Active NPI
Melinda B Goodman, PH.D
- Psychologist
- Baltimore, MD
National Provider Identifier
1578879672
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 4822
- Practice address
- 1414 Key Hwy
Ste 300M
Baltimore, MD 21230-5142 - Phone
- (352) 359-3227
- NPI assigned
- Aug 26, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PS016706 | PA | |
| Psychologist | 103T00000X | 4822 | MD | Primary |
Addresses
Primary practice location
1414 Key Hwy
Ste 300M
Baltimore, MD 21230-5142
Mailing address
1414 Key Hwy
Ste 300M
Baltimore, MD 21230-5142
Phone (352) 359-3227
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20101216000637 | MD | Practitioner - Clinical Psychologist | 8123216298 | Practice locations: Baltimore, MD |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4822 | MD | MD | Psychologist |
| PS016706 | PA | MD | Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Harbor Counseling LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Clinical Social Worker
- Baltimore, MD
- NPI 1609160126
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1282780800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1564358400000",
"number": "1578879672",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1414 KEY HWY",
"address_2": "STE 300M",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212305142",
"telephone_number": "352-359-3227"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1414 KEY HWY",
"address_2": "STE 300M",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212305142",
"telephone_number": "352-359-3227"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOODMAN",
"first_name": "MELINDA",
"middle_name": "B",
"name_prefix": "Ms.",
"credential": "PH.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-08-26",
"last_updated": "2019-07-29",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "PA",
"license": "PS016706",
"primary": false
},
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MD",
"license": "4822",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.